138 articles - From Friday Jul 15 2022 to Friday Jul 22 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Clin Gastroenterol Hepatol |
AGA Clinical Practice Update on Management of Subepithelial Lesions Encountered During Routine Endoscopy: Expert Review. Methods This expert review was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the CPUC and external peer review through standard procedures of Clinical Gastroenterology and Hepatology. Since this was not a systematic review, we did not carry out any formal rating of the quality of evidence or strength of the presented considerations. |
| Gastroenterology |
AGA Clinical Practice Update: Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Lean Individuals: Expert Review. BEST PRACTICE ADVICE 14: The therapeutic role of glucagon-like peptide-1 agonists and sodium-glucose cotransporter-2 inhibitors in the management of lean NAFLD is not fully defined and requires further investigation. BEST PRACTICE ADVICE 15: Hepatocellular carcinoma surveillance with abdominal ultrasound with or without serum a-fetoprotein twice per year is suggested in patients with lean NAFLD and clinical markers compatible with liver cirrhosis. |
| Gastrointest Endosc |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
Comparative Burden of Metabolic Dysfunction in Lean NAFLD vs. Non-Lean NAFLD - A Systematic Review and Meta-Analysis. The current analysis highlights the weight-dependent nature of metabolic dysfunction in NAFLD. Lean subjects with NAFLD were significantly less metabolically unhealthy than were obese and overweight persons with NAFLD. An overreliance on metabolic dysfunction in defining fatty liver will be a flaw in potentially excluding previously characterized NAFLD. |
Global Hospitalization Trends for Crohn's Disease and Ulcerative Colitis in the 21st Century: A Systematic Review with Temporal Analyses. Hospitalization rates for IBD are stabilizing in countries in Stage 3, whereas newly industrialized countries in Stage 2 have rapidly rising hospitalization rates, contributing to an increasing burden on global healthcare systems. |
| Gastrointest Endosc |
RELIABILITY OF PREOPERATIVE PANCREATIC NEUROENDOCRINE TUMORS GRADING ON ENDOSCOPIC ULTRASOUND SPECIMENS: A SYSTEMATIC REVIEW WITH META-ANALYSIS OF AGGREGATE AND INDIVIDUAL DATA. EUS is an accurate technique in defining grading in patients with PanNENs, but there is still a margin of error that will need to be focused on with future studies to minimize the risk of over/undertreatment. |
| Inflamm Bowel Dis |
A Systematic Review of Crohn's Disease Case Definitions in Administrative or Claims Databases. Health services researchers should validate case definitions in their research cohorts. When such validation cannot be performed, we recommend using a more complex case definition. Studies without a validated CD case definition should use sensitivity analyses to confirm the robustness of their results. |
| J Hepatol |
Hepatitis B Virus Reactivation Associated with New Classes of Immunosuppressants and Immunomodulators: A Systematic Review, Meta-analysis, and Expert Opinion. Consensus on definition and methods of reporting HBVr along with inclusion of HBsAg+, and HBsAg-/anti-HBc+ patients in clinical trials are needed to provide reliable data on HBVr risk associated with immunosuppressive or immunomodulatory therapies. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Sugar-sweetened beverages, artificially sweetened beverages and natural juices and risk of inflammatory bowel disease: a cohort study of 121,490 participants. Our findings suggest an association between consumption of sugar-sweetened beverages, rather than artificially sweetened beverages or natural juices, and IBD risk. |
Universal HBV vaccination dramatically reduces the prevalence of HBV infection and incidence of hepatocellular carcinoma. Universal HBV vaccination markedly reduces the prevalence of chronic HBV infection and may contribute to the decreased incidences of HCC and hepatic events. |
| Am J Gastroenterol |
Combining FIB-4 and liver stiffness into the FIB-5, a single model that accurately predicts complications of portal hypertension. We combined LS and the individual components of the FIB-4 into a single scoring system (FIB-5, which can help identify patients with compensated liver disease at risk of developing complications of PH. |
Comorbid chronic diseases and survival in compensated and decompensated cirrhosis: a population-based study. In patients with cirrhosis, a focus on comorbid chronic disease(s) as potential management targets may help avoid premature mortality regardless of etiology. Multidisciplinary care early in the clinical course of cirrhosis is needed in addition to the current focus on management of complications of portal hypertension. |
Comorbidity influences the comparative safety of biologic therapy in older adults with inflammatory bowel diseases. Among adults =60 years with IBD initiating biologic therapy, both vedolizumab and ustekinumab were associated with lower rates of infection-related hospitalizations than anti-TNF therapy for those with high comorbidity burden. |
Early Liver Transplantation for Severe Alcohol-Associated Hepatitis and a History of Prior Liver Decompensation. Prior liver decompensation was associated with higher risk of post-LT mortality and harmful alcohol use. These results are a preliminary safety signal and validate first decompensation as a criterion for consideration in early LT for AH patients. However, the high 3-year survival suggests a survival benefit for early LT and the need for larger studies to refine this criterion. These results suggest that prior liver decompensation is a risk factor, but not an absolute contraindication to early LT. |
High accuracy in classifying endoscopic severity in ulcerative colitis using convolutional neural network. We have developed a highly accurate new, automated way of evaluating endoscopic images from UC patients. We have demonstrated how our DL model is capable of distinguishing between al four MES levels of activity. This new automated approach may optimize and standardize the evaluation of disease severity measured by the MES across centres no matter the level of medical expertise. |
Idiosyncratic Drug-Induced Liver Injury Associated with and Without Drug-Reaction with Eosinophilia and Systemic Symptoms. A limited number of drugs cause DwD, representing a fifth of patients with DILI. DwD is characterized by lesser degrees of liver injury and mortality likely due to earlier presentation. |
Pediatric to adult transfer of care in patients with pancreas disease: Recommendations for care and research opportunities. We emphasize the unique needs of these patients as they transfer to adult healthcare and the need for further research. The goal of improved transitional care and transfer is to enhance the services provided to adolescents/young adults with pancreatic disease in both healthcare settings and improve continuity of follow-up care. |
REDUCTION IN NOSOCOMIAL INFECTIONS IN PATIENTS with CIRRHOSIS DURING THE COVID-19 ERA COMPARED TO PRE-COVID-19: IMPACT OF MASKING AND RESTRICTING VISITATION? We found that despite a higher admission MELD-Na, qSOFA and WBC count, and requiring a longer ICU stay, COVID-era patients developed lower NIs (3% vs 10%, p<0.001) and had higher liver transplant rates versus pre-COVID patients. COVID-era restrictions could reduce NI in critically ill patients with cirrhosis. |
| Clin Gastroenterol Hepatol |
AGILE 3+ Score for the diagnosis of advanced fibrosis and for predicting liver-related events in NAFLD. Depending on resource availability, clinical setting, and the risk scenarios AGILE 3+ is an accurate and valid alternative to FIB-4 and LSM for the noninvasive assessment of disease severity and prognosis in NAFLD patients. |
Artificial intelligence-assisted colonoscopy for colorectal cancer screening: a multicenter randomized controlled trial. In this multicenter RCT in asymptomatic patients, AI-assisted colonoscopy improved overall ADR, advanced ADR and ADR of both expert and non-expert attending endoscopists. |
Artificial Intelligence allows Leaving-in-Situ colorectal polyps. In this study, CADx without advanced imaging exceeded the benchmarks required for optical diagnosis of colorectal polyps. CADx could help implement cost-saving strategies in colonoscopy by reducing the burden of polypectomy and/or pathology. |
Carvedilol achieves higher hemodynamic response and lower rebleeding rates than propranolol in secondary prophylaxis. Carvedilol induces more marked reductions in HVPG than propranolol in secondary prophylaxis of variceal bleeding, and is thus, associated with lower rates of rebleeding, liver-related death and non-bleeding further decompensation. |
Characteristics of older patients with immunotolerant chronic hepatitis B virus infection. In a large North American population, over 50% of adults in the IT phase of CHB were =30 and 20% =40 years old, but older IT patients had similar characteristics and rates of transition as younger IT patients. |
Differential relapse patterns after discontinuation of entecavir vs tenofovir disoproxil fumarate in chronic hepatitis B. TDF and ETV have differential relapse patterns but are associated with similar rates of HBsAg loss and retreatment following discontinuation. Finite therapy can be considered for CHB patients on either TDF or ETV therapy. |
Early ultrasound response and progressive transmural remission after treatment with ustekinumab in Crohn's disease. In this first international, multi-center, interventional study, IUS showed that ustekinumab-treated CD patients achieved progressive IUS response (46.3%) and transmural remission (24.1%) through week 48 with a more robust response in the colon and biologic-naïve patients. |
Humoral and cellular immune response after third and fourth SARS-CoV-2 mRNA vaccination in liver transplant recipients. A third and fourth SARS-CoV-2 vaccination effectively increases the humoral and cellular immune response of LTR, but to a lesser extent than in HC. A fourth vaccination should be generally considered in LTR. |
Hydronidone for the treatment of liver fibrosis related to chronic hepatitis B: a Phase 2 randomized controlled trial. Hydronidone plus entecavir showed clinically significant histological improvement of liver fibrosis in CHB patients and the dose of 270 mg showed best efficacy of fibrosis regression. Further studies are required to assess the long-term effectiveness of hydronidone in regression of hepatic fibrosis. number, NCT02499562. |
Risk of recurrent acute arterial events associated with thiopurines and anti-TNF in inflammatory bowel diseases. In a nationwide cohort study of patients with IBD and a previous history of acute arterial event, both exposure to anti-TNF and thiopurines were associated with a decreased risk of recurrent acute arterial events. |
| Endoscopy |
Nasal breathing is superior to oral breathing in performing and undergoing transnasal endoscopy: a randomized trial. Nasal breathing is superior to oral breathing in performing and undergoing transnasal endoscopy. Nasal breathing led to good visibility of the upper-middle pharynx, improved endoscopic operability and patient tolerance, and showed safety by decreasing pharyngeal bleeding. |
Risk of residual neoplasia after a non-curative colorectal ESD for malignant lesions; a multinational study. Lymphatic permeation or poor differentiation warrants surgery due to the high risk of lymph node metastasis, mainly in >SM1 cancers. In the remaining cases, en-bloc and R0 resections determine low risk of residual lesion in the wall. Our scores can be a useful tool for the management of patients submitted to non-curative colorectal ESDs. |
| Gastroenterology |
Altered gut microbiome composition and function are associated with gut barrier dysfunction in healthy relatives of patients with Crohn's disease. Gut microbiome community and pathways are associated with changes in gut barrier function. These findings may identify potential microbial targets to modulate gut barrier. |
An exosome-based transcriptomic signature for noninvasive, early detection of patients with pancreatic ductal adenocarcinoma: A multicenter cohort study. In this study, an exosome-based liquid-biopsy signature for the noninvasive and robust detection of patients with PDAC was developed. |
SMAD4 suppresses colitis-associated carcinoma through inhibition of CCL20/CCR6-mediated inflammation. Regulation of mucosal inflammation is central to SMAD4 tumor suppressor function in the colon. A key downstream node in this regulation is suppression of epithelial CCL20 signaling to CCR6 in immune cells. Loss of SMAD4 in the colon epithelium increases CCL20 expression and chemoattraction of CCR6+ immune cells, contributing to greater susceptibility to colon cancer. |
| Gastrointest Endosc |
Clinical utility of purgative bowel preparation prior to capsule endoscopy: A multicenter, blinded, randomized controlled trial. Use of purgative bowel preparation prior to CE does not improve diagnostic yield or small bowel visualization and is associated with lower patient tolerance. |
Long-term rebleeding rate and predictive factors of rebleeding after capsule endoscopy in patients with obscure gastrointestinal bleeding. Rebleeding is common during the long-term follow-up of patients with OGIB. Careful follow-up is required for patients with liver cirrhosis or previous massive bleeding. |
Validation of a natural language processing algorithm to identify adenomas and measure adenoma detection rates across a health system: a population-level study. Using a population-based sample from Ontario, our NLP algorithm was highly accurate and was used at the system level to measure ADR. |
| Hepatology |
Hepatocyte-derived MASP1-enriched small extracellular vesicles activate hepatic stellate cells to promote liver fibrosis. ARRB1 upregulates the release of hepatocyte-derived MASP1-enriched small EVs by regulating the autophagic-lysosomal/multivesicular body pathway and Rab27A. Hepatocyte-derived MASP1 activates HSCs to promote liver fibrogenesis through p38 MAPK/ATF2 signaling. Thus, MASP1 is a novel and pivotal therapeutic target in liver fibrosis. |
Hepatocyte ß-Catenin Loss is Compensated by Insulin-mTORC1 Activation to Promote Liver Regeneration. Insulin-mTORC1 activation compensates for ß-catenin loss to enable LR after PH. mTORC1 signaling in hepatocytes itself is critical to both homeostasis and LR and is only partially compensated by ß-catenin activation. Dual inhibition of ß-catenin and mTOR may have notable untoward hepatotoxic side effects. |
Inhibition of mPGES-2 ameliorates non-alcoholic steatohepatitis by activating NR1D1 via heme. Our study indicates the pathogenic role of mPGES-2 and outlines the mechanism in mediating NAFLD, thereby highlighting the therapeutic potential of mPGES-2 inhibition in liver steatosis and steatohepatitis. |
| Inflamm Bowel Dis |
Clinical, Endoscopic, and Radiological Effectiveness of Ustekinumab in Bio-naïve Versus Bio-experienced Patients With Crohn's Disease: Real-world Experience From a Large Canadian Center. In this large real-world cohort of CD patients with complex phenotypes and high rates of prior biologic exposure, we observed that ustekinumab was effective and safe with higher rates of improvement in bio-naïve subjects across a range of end points. |
Mycobiome and Inflammatory Bowel Disease: Role in Disease Pathogenesis, Current Approaches and Novel Nutritional-based Therapies. In this review, we discuss the impact of specific fungi on disease pathogenesis, with a focus on the highly virulent genus Candida and how the presence of certain co-enzymes impacts its virulence. In addition, we evaluate current gut microbiome-based therapeutic approaches with the intention of better understanding the mechanisms behind novel therapies. |
| J Crohns Colitis |
CD147 Targeting by AC-73 Induces Autophagy and Reduces Intestinal Fibrosis Associated with TNBS Chronic Colitis. CD147 is a potential new target for controlling intestinal fibrosis and its inhibitor, AC-73, might represent a potential new anti-fibrotic therapeutic option in IBD. |
| J Hepatol |
Clinical course of non-alcoholic fatty liver disease and the implications for clinical trial design. In this population-based cohort with 23 years of longitudinal follow-up, NAFLD was slowly progressive, with liver-related outcomes affecting only a small proportion of people. Reduction in liver related endpoints in clinical trials require large sample sizes and long follow-up. |
Combination of G-CSF and a TLR4 inhibitor reduce inflammation and promote regeneration in a mouse model of ACLF. TLR4 inhibition with TAK-242 rescued G-CSF-driven cell death, inflammation, enhanced tissue repair, and significantly induced regeneration thus suggesting that the combination of G-CSF and TAK-242 is a novel approach for the treatment of ACLF. |
Identification of an FXR-modulated liver-intestine hybrid state in iPSC-derived hepatocyte-like cells. In contrast to physiological hepatocyte precursor cells and mature hepatocytes, HLC co-express liver and hybrid genes in the same cell. Targeted modification of the FXR gene regulatory network improves their differentiation by suppressing intestinal traits whilst inducing hepatocyte features. |
| Neurogastroenterol Motil |
Effect of intracolonic volume on gastric sensory-motor responses in constipation-predominant irritable bowel syndrome. The volume of the colonic contents modulates satiety in patients with IBS-C, due to a general visceral pan-hypersensitivity. These effects should be considered in the choice of treatment for constipation in these patients. |
Virtual Tai Chi program for patients with irritable bowel syndrome with constipation: Proof-of-concept feasibility trial. Our data provide preliminary evidence of the feasibility of a Tai Chi intervention for IBS-C, show promise for improving outcomes, and identify more streamlined data collection as an area for further program improvement. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Clin Gastroenterol Hepatol |
| Gastrointest Endosc |
| Hepatology |
Acute Hepatitis of Unknown Origin in Children: Behind the Statistics. Nevertheless, other hypotheses are being investigated to justify the severity of the clinical picture which is not typical of this type of virus. This review aims to summarize the current knowledge about the outbreak, highlight the suggested working hypotheses, and report the public health measures undertaken to tackle the outbreak. |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| J Crohns Colitis |
| J Hepatol |